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Home My WebLink About306054 (9) CITY OF CARMEL, INDIANA VENDOR: 00351464 CHECKAMOUNT: $*******454.00*ONE CIVIC SQUARE INDIANA RURAL WATER ASSOC CHECK NUMBER: 306054 CARMEL, INDIANA 46032 PO BOX 242 ZIONSVILLE IN 46077-0242 CHECK DATE: 12/12/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 16-07213 454.00 OTHER EXPENSES N .Q E ca O m O a UJ D co O Z �- Q a O c o * 1= z Q Z U. U p CO ,�+' O Q a Q Q CN '++ Q cQ3 a c W L O M E L N Q d U c - ° t Q Q 12 rnt co LLZ 3 0 t > L. z �,, c CM 2 � ZX5 0 o Z O CO am Z Zclo a ccfiZaN O a U v Remit To: Indiana Rural Water Association PO Box 242 Zionsville, IN 46077-0242 ATTN: ACCOUNTS PAYABLE Invoice BILL TO City of Carmel DATE INVOICE NO. 3450 W 131 St. St. 11/28/2016 16-07213 Carmel, IN 460747 1------------------------------------------ IRWA is proud to be funded solely by membership dues and registration fees i with no federal government assistance. ; 1-----------------------------------------J Membership Renewal Date 2/17/2017 Questions? MaryJane Peters,Administrative Director MaryJane@indianaruralwater.org Telephone-866-895-4792 P.O. No. TERMS Fax-855-202-7298 K1-112816 Due on receipt DESCRIPTION AMOUNT IRWA Water Institute, Clarion Hotel & Conference Center, Columbus, IN - December 5-7, 2016 Monday-Wastewater Technical Sessions- Kole Bassett 40.00 Tuesday Only- Brian Tolan,Jacen Rayle, Matthew Bickel,William Bell,Jerry 300.00 Cloud Meals: ML(1);TL(5) 114.00 11/28/2016 E-mail Subtotal $454.00 Payments/Credits $0.00 Balance Due $454.00 1�IT� REGISTRATION FORM - IRWA Water Institute - December 5 - 7, 2016 Please print or type one form for EACH ATTENDEE! Attendee Information: Billing Information: Nameyo� I, A S 51'.- ► l Company Name: CAAjMej A, TitleO•2r'A 4 o/ Billing Contact try'I C.kJ le -T Guest's name; if attending 1 Address 3 Ll, Dy,) Address 3 L{�0 w • 131 r� S I City rn AY-M-1 SX_ __:� Zip City C,&r M'e-1 St':I^) Zip 0-7 Y Telephone Telephone 3)�, 733- aF J SFax 3 f 7- 732- ave 3 SS�2ttF� C�1/^1CI. IIR.GaJ Fax �J1Z•-1��— oZ-C�Fj3 E-mail E-mail invoice VaA u .Roo I will be submitting contact hours for- tease pleanly I Water ❑ Wastewatev& Well Drillers/Pump Installers❑ Purchase Order# Y5= Il 25k Engineer PDHs ❑ None ❑ MONDAY SESSIONS IRWA Member Non-Member Preventative Maintenance/CUPPS(8:00a-Noon) 11 $40.00 ❑ $80.00 $ Well Drillers&Pump Installers-Part 1&2(9:00a-4:00) 11 $60.00 ❑$120.00 $ Utility Board Members/Managers-(9:00a-4:00) 11 $60.00 ❑$120.00 $ Revised Total Coliform Rule Level 2 Assessment(1:00p-5:00) ❑ $40.00 ❑$80.00 $ Wastewater Technical Sessions-(1:00p-5:00) ,$40.00 ❑ $80.00 $ L4 0 1—' a TUESDAY&WEDNESDAY SESSIONS IRWA Member Non-Member ° Tuesday& Wednesday ❑ $100.00 ❑ $200.00 $ 11 Tech nical/General Sessions 11Utility Business Forum CL 0 �Tuesday ONLY ❑ $60.00 ❑ $120.00 $ 21 M ❑ Technical/General Sessions ❑ Utility Business Forum Wednesday ONLY ❑ Y $40.00 ❑ $80.00 $ s ❑ Technical/General Sessions o p MEALS $� Monday Lunch Tuesday Lunch Tuesday Reception Attendee > $19.00 Attendee ❑ $19.00 Attendee ❑ $ No Fee Guest ❑ $19.00 Guest ❑ $19.00 Guest ❑ $ No Fee One BOARD MEMBER or MAYOR per system is One BOARD MEMBER or MAYOR per system is NO CHARGE-Please check if planning to attend! entitled to(1)COMPLIMENTARY Monday Lunch I entitled to(1)COMPLIMENTARY Tuesday Lunch GAMBOLD EDUCATION FUND DONATION(MGEF) $ Mon $ fib_ + Tues/Wed $ + Lunch $ 1!!�j tb + MGEF $ _ $ q 21 . 0-6 MAIL:IRWA E-MAIL: FAX: Bill us PO Box 242 Zionsville,IN 46077-0242 MaryJane@indianaruralwater.org 855-202-7298 ❑ Credit Card E-mail cc receipt: - We welcome registrations on-site. Visa MC Discover AmExp Please submit cancellation requests in writing. # Exp.: No refunds after December 2,2016. NAME ON CARD: Security: Questions- MaryJane Peters Telephone:866-895-4792 SIGNATURE Billing Zip Code: E-mail: MaryJane@indianaruralwater.org REGISTRATI®Id FORM - IRWA Water Institute - December 5 - 7, 2016 Please print or type one form for EACH ATTENDEE! Attendee Information: 11 Billing Information: Name P �1 +� l n 1 A rJ Company Name: C�c Vxa g��l& Title 2k o-CAP: CA I J D 6?�V S 6/�— Billing Contact /`.,,`� Guest's name; if attending Address 3 50 \Q ?485� - Address (4 ED w. 13 I s S+ City (vn� - St *.S Zip City ('Ar/-",P_` st1n) Zip 6 0 �) Telephone �-Z -�3� — o��S'S�_ Telephone /7- 73?-d8�)Fax 17 7 31- o$'3 Fax ��. E-mail�'}77 I G� � Cath P.I. I R,4o v � V-_ E-mail invoice I will be submitting contact hours for- yPlease print clew-fry Wate� Wastewater ❑ Well Drillers/Pump Installers❑ Purchase Order# Engineer PDHs ❑ None ❑ MONDAY SESSIONS IRWA Member Non-Member Preventative Maintenance/CUPPS(8:00a-Noon) ❑$40.00 ❑$80.00 $ Well Drillers&Pump Installers-Part 1&2(9:00a-4:00) 11$60.00 ❑$120.00 $ Utility Board Members/Managers-(9:00a-4:00) 11$60.00 ❑$120.00 $ Revised Total Coliform Rule Level 2 Assessment(1:00p-5:00) 11$40.00 ❑$80.00 $ C Wastewater Technical Sessions-(1:00p-5:00) 11$40.00 ❑$80.00 $ a V TUESDAY&WEDNESDAY SESSIONS IRWA Member Non-Member 0 Tuesday& Wednesday ❑ $100.00 ❑ $200.00 $ M ❑ Technical/General Sessions ❑ Utility Business Forum CL cc) 0 —►Tuesday ONLY $60.00 ❑ $120.00 $21 �� ATechnical/General Sessions ❑ Utility Business Forum ® Wednesday ONLY ❑ $ Y $40.00 ❑ $80.00 s ❑ Technical/General Sessions $ MEALS Monday Lunch Tuesday Lunch Tuesday Reception Attendee ❑ $19.00 Attendee „ $19.00 Attendee ❑ $ No Fee Guest ❑ $19.00 Guest ❑ $19.00 Guest ❑ $ No Fee One BOARD MEMBER or MAYOR per system is One BOARD MEMBER or MAYOR per system is NO CHARGE-Please check if planning to attend! entitled to(1)COMPLIMENTARY Monday Lunch entitled to(1)COMPLIMENTARY Tuesday Lunch GAMBOLD EDUCATION FUND DONATION(MGEF) $ Mon Tues/Wed $ (Ct�rCD + Lunch $ Lct, + MGEF $ _ $ MAIL:IRWA E-MAIL: FAX: t5ilfBill us PO Box 242 Zionsville,IN 46077-0242 MaryJane@indianaruralwater.org 855-202-7298 ❑ Credit Card E-mail cc receipt: - We welcome registrations on-site. Visa MC Discover AmExp Please submit cancellation requests in writing. # Exp.: No refunds after December 2,2016. NAME ON CARD: Security: Questions- MaryJane Peters Telephone:866-895-4792 SIGNATURE Billing Zip Code: E-mail: MaryJane@indianaruralwater.org REGISTRATION FORM - IRWA Water Institute m December 5 - 72 2016 Please print or type one form for EACH ATTENDEE! Attendee Information: Billing Information: Names G�k1 IC.P V `� Company Name: --C1.�(' 1M [L� Title ('k,/,,&40[L Billing Contact �r-'Irk L��rD Guest's name; if attending Address c� 5� ��1 �� I !sat:AddressT S y J ® LJ . �3 1 C City COM—IPY'Y SQIA.� Zip. City St 1'J Zip cl b()? Telephone c�(Z -' ?J3^v� 5_S Telephone�r�)-73J-aSs'� Fax.�17-233-anJ3 3�..-Z �� Fax E-mail 1 fa� Cart.Y_ r n,Qn✓ E-mail invoice K (/ I will be submitting contact hours for- lease print e MT- Water Wastewater ❑ Well Drillers/Pump Installers❑ Purchase Order# V-1 it as ..n Engineer PDHs ❑ None ❑ MONDAY SESSIONS IRWA Member Non-Member Preventative Maintenance/CUPPS(8:00a-Noon) ❑$40.00 ❑$80.00 $ Well Drillers&Pump Installers-Part 1&2 (9:00a-4:00) 11$60.00 ❑$120.00 $ Utility Board Members/Managers-(9:00a-4:00) ❑$60.00 ❑$120.00 $ Revised Total Coliform Rule Level 2 Assessment(1:00p-5:00) ❑$40.00 ❑$80.00 $ Wastewater Technical Sessions-(1:00p-5:00) 11$40.00 ❑$80.00 $ a TUESDAY&WEDNESDAY SESSIONS IRWA Member Non-Member ° Tuesday& Wednesday ❑ $100.00 ❑ $200.00 $ M M ❑ Technical/General Sessions ❑ Utility Business Forum C no 0 —►Tuesday ONLY $60.00 ❑ $120.00 $21 � M ,�, Technical/General Sessions ❑ Utility Business Forum Y Wednesday ONLY ❑ $40.00 ❑ $80.00 $ U ❑ Technical/General Sessions MEALS $ I� 6 Monday Lunch Tuesday Lunch Tuesday Reception Attendee ❑ $19.00 Attendee ( $19.00 Attendee ❑ $ No Fee Guest ❑ $19.00 Guest ❑ $19.00 Guest ❑ $ No Fee One BOARD MEMBER or MAYOR per system is One BOARD MEMBER or MAYOR per system is NO CHARGE-Please check if planning to attend! entitled to(1)COMPLIMENTARY Monday Lunch entitled to(1)COMPLIMENTARY Tuesday Lunch GAMBOLD EDUCATION FUND DONATION(MGEF) $ Mon $ r� + Tues/Wed $_�d + Lunch $ 1,Q_tI0 + MGEF $ _ $ �Q� MAIL:IRWA E-MAIL: FAX: Bill us PO Box 242 Zionsville,IN 46077-0242 MaryJane@indianaruralwater.org 855-202-7298 ❑ Credit Card E-mail cc receipt: — We welcome registrations on-site. Visa MC Discover AmExp Please submit cancellation requests in writing. # Exp.: No refunds after December 2,2016. Questions- NAME ON CARD: Security: MaryJane Peters Telephone:866-895-4792 SIGNATURE Billing Zip Code: E-mail: MaryJane@indianaruralwater.org REGISTRATION FORM - IRWA Water Institute - December 5 - 7, 2016 Please print or type one form for EACH ATTENDEE! Attendee Information: j� Billing Information: Name nnl�- k r�UJ 13" <---6-le I Company Name: C-n.r'ri-,# 1. U_�CdjLA, Title Billing Contact Lr'r-,* Lt=,\T LLZ t t Guest's name; if attending Address 54,5D tk_�) t 3LS�r Address 3�) 0 W. �) ` / f City �Y�'l.G L St�� Zip _ city CArV^f-1 stJ/j zip c/66 7V .._.. .. _ Telephone Z-_7 �3 a 5S Telephone ,317-?33-AS1 J Fax 3l)-733 - Z&f 3 3 �� .� L E-mail r1\ p i C�� CQ rM�I � j r%.;00 Fax /� //�� E-mail invoice lc:,%J�A l A Irr1nA . ir7,C�(w I will be submitting contact hours for- Please print CMy Water/k Wastewater ❑ Well Drillers/Pump Installers❑ Purchase Order# ICA Lugs l L Engineer PDHs ❑ None ❑ MONDAY SESSIONS IRWA Member Non-Member Preventative Maintenance/CUPPS(8:00a-Noon) ❑$40.00 ❑$80.00 $ Well Drillers&Pump Installers-Part 1&2(9:00a-4:00) ❑ $60.00 11$120.00 $ Utility Board Members/Managers-(9:00a-4:00) ❑$60.00 ❑$120.00 $ Revised Total Coliform Rule Level 2 Assessment(1:00p-5:00) ❑$40.00 ❑ $80.00 $ -6 Wastewater Technical Sessions-(1:00p-5:00) ❑ $40.00 ❑$80.00 $ C W VM TUESDAY&WEDNESDAY SESSIONS IRWA Member Non-Member Tuesday& Wednesday ❑ $100.00 ❑ $200.00 $ M ❑ Technical/General Sessions ❑ Utility Business Forum CL 01 -0-Tuesd ONLY ®x$60.00 ❑ $120.00 $ (D 6 Technical/General Sessions ❑ Utility Business Forum ® Wednesday ONLY ❑ $40.00 ❑ $80.00 $ Y t ❑ Technical/General Sessions ov " MEALS $ Cl Monday Lunch Tuesday Lunch Tuesday Reception Attendee ❑ $19.00 Attendee $19.00 Attendee ❑ $ No Fee Guest ❑ $19.00 Guest ❑ $19.00 Guest ❑ $ No Fee One BOARD MEMBER or MAYOR per system is One BOARD MEMBER or MAYOR per system is NO CHARGE-Please check if planning to attend! entitled to(1)COMPLIMENTARY Monday Lunch I entitled to(1)COMPLIMENTARY Tuesday Lunch GAMBOLD EDUCATION FUND DONATION(MGEF) $� Mon $ `—+Tues/Wed $�tS)+ Lunch $ kq JZ�V MGEF MAIL:IRWA E-MAIL: FAX. ill us PO Box 242 MaryJane@indianaruralwater.org 855-202-7298 Zionsville,IN 46077-0242 ❑ Credit Card E-mail cc receipt: - We welcome registrations on-site. Visa MC Discover AmExp Please submit cancellation requests in writing. # Exp.: No refunds after December 2,2016. NAME ON CARD: Security: Questions- MaryJane Peters Telephone:866-895-4792 SIGNATURE BillingZi Code: p E-mail. MaryJane@indianaruralwater.org REGISTRATION FORM - IRWA Water Institute - December 5 - 7, 2016 Please print or type one form for EACH ATTENDEE! Attendee Information: Billing Information: Name l 1 <P►*-� I� Company Name: l= TitleF0 ^fn n1 Billing Contact �r�'��rt� lI Guest's name; if attending Address :FS%40_�,Jl5-�- Address 3`-/.1'6 %-J. i � ) S T S4 City CO3r-rne,1 SMS Zip City CA 1,(W-,RA St !A Zip L4 1007 Telephone (,-7-'7 3 3 S5�1 Telephone 317-_M- a8 S— Fax 31)-73)-160 Fax E-mail L, be-11 P.cevm )• i 1r\,!�e U E-mail invoiceY�. rinty I will be submitting contact hours for- Please p ^C Water Wastewater 13 Well Drillers/Pump Installers❑ Purchase Order# 4�-1 t Las I LO Engineer PDHs ❑ None ❑ MONDAY SESSIONS IRWA Member Non-Member Preventative Maintenance/CUPPS(8:00a-Noon) ❑$40.00 ❑$80.00 $ Well Drillers&Pump Installers-Part 1&2(9:00a-4:00) ❑ $60.00 11$120.00 $ Utility Board Members/Managers-(9:00a-4:00) 11 $60.00 ❑$120.00 $ Revised Total Coliform Rule Level 2 Assessment(1:00p-5:00) ❑$40.00 ❑ $80.00 $ -6 Wastewater Technical Sessions-(1:00p-5:00) ❑$40.00 13 $80.00 $ c a, TUESDAY&WEDNESDAY SESSIONS IRWA Member Non-Member ° Tuesday& Wednesday ❑ $100.00 ❑ $200.00 $ C ❑ Technical/General Sessions ❑ Utility Business Forum CL ` c, 0, —►Tuesday ONLY ❑ $60.00 ❑ $120.00 $ G M Ek"—Technical/General Sessions ❑ Utility Business Forum ® Wednesday ONLY ❑ $40.00 ❑ $80.00 $ Y t ❑ Technical/General Sessions CC U U '' MEALS $�� Monday Lunch Tuesday Lunch Tuesday Reception Attendee ❑ $19.00 Attendee $19.00 Attendee ❑ $ No Fee Guest ❑ $19.00 Guest ❑ $19.00 Guest ❑ $ No Fee One BOARD MEMBER or MAYOR per system is One BOARD MEMBER or MAYOR per system is NO CHARGE-Please check if planning to attend! entitled to(1)COMPLIMENTARY Monday Lunch I entitled to(1)COMPLIMENTARY Tuesday Lunch GAMBOLD EDUCATION FUND DONATION(MGEF) $ Mon $ ..sem + Tues/Wed $ �D x'00+ Lunch $14—M+ MGEF $ �- _ $ � MAIL:IRWA E-MAIL: FAX: ill us PO Box 242 Zionsville,IN 46077-0242 MaryJane@indianaruralwater.org 855-202-7298 ❑ Credit Card E-mail cc receipt: - We welcome registrations on-site. -- Visa MC Discover AmExp Please submit cancellation requests in writing. # Exp.: No refunds after December 2,2016. Questions- NAME ON CARD: Security: MaryJane Peters Telephone:866-895-4792 SIGNATURE BillingZi Code: p E-mail: MaryJane@indianaruralwater.org t... REGISTffiq RATION FORM - IRWA Wate�Inst�itute! December 5 - 7, 2016 Please print or type one form for EACH ATTENDEE! Attendee Information: Billing Information: -�— Company Name: Name J C�►'Lq C'[00/) --�� Title n J Jap ey S o� Billing Contact Guest's name; if attending Address 34=_t--1_�LZ� (S$' S — Address 3 y d W 13 1 s 7 City Ca3rm*V—t Stl__�ip City ( Ar A-T_1i St h A Zip c4 6 0 7 Y Telephone Telephone?P-73348_)_ Fax 317-733-a6J'3 ` E-mail r 1 o m C�l`I►�. t r,3.500 Fax S Z a ,e r E-mail invoicev I will be submitting contact hours for- Please print a y Water EYWastewater ❑ Well Drillers/Pump Installers❑ Purchase Order# KL l lla Engineer PDHs ❑ None ❑ MONDAY SESSIONS IRWA Member Non-Member Preventative Maintenance/CUPPS(8:00a-Noon) 11 $40.00 ❑$80.00 $ Well Drillers&Pump Installers-Part 1&2(9:00a-4:00) ❑ $60.00 ❑ $120.00 $ Utility Board Members/Managers-(9:00a-4:00) 11$60.00 ❑$120.00 $ Revised Total Coliform Rule Level 2 Assessment(1:00p-5:00) 11$40.00 ❑$80.00 $ -6 Wastewater Technical Sessions-(1:00p-5:00) 11 $40.00 ❑$80.00 $ C d TUESDAY&WEDNESDAY SESSIONS IRWA Member Non-Member ° Tuesday& Wednesday ❑ $100.00 ❑ $200.00 $ r ❑ Technical/General Sessions ❑ Utility Business Forum CL 0 —►Tuesday ONLY 8 $60.00 ❑ $120.00 $ ��0 Technical/General Sessions ❑ Utility Business Forum ® Wednesday ONLY ❑ $40.00 ❑ $80.00 $ Y r ❑ Technical/General Sessions p o MEALS $ / Monday Lunch Tuesday Lunch Tuesday Reception Attendee ❑ $19.00 Attendee A $19.00 Attendee ❑ $ No Fee Guest ❑ $19.00 Guest ❑ $19.00 Guest ❑ $ No Fee One BOARD MEMBER or MAYOR per system is One BOARD MEMBER or MAYOR per system is NO CHARGE-Please check if planning to attend! entitled to(1)COMPLIMENTARY Monday Lunch I entitled to(1)COMPLIMENTARY Tuesday Lunch GAMBOLD EDUCATION FUND DONATION(MGEF) $ Mon $ --- - '+ Tues/Wed $ •Gb + Lunch $ P5)-V>+ MGEF $ �� $ `74 MAIL:IRWA E-MAIL: FAX. ill us PO Box 142 Zionsville,IN 46077-0242 MaryJane@indianaruralwater.org 855-202-7298 ❑ Credit Card E-mail cc receipt: - We welcome registrations on-site. Visa MC Discover AmExp Please submit cancellation requests in writing. # Exp.: No refunds after December 2,2016. Questions- NAME ON CARD: Security: MaryJane Peters SIGNATURE BillingZi Code: Telephone:866-895-4792 p E-mail: MaryJane@indianaruralwater.org